Title:Brief Academic Review and Clinical Practice Guidelines for Pediatric Atopic Dermatitis

VOLUME: 17 ISSUE: 3

Author(s):Yue Bo Yang, Amir Gohari and Joseph Lam*

Affiliation:Faculty of Medicine, University of British Columbia, Vancouver, Faculty of Medicine, University of British Columbia, Vancouver, Departments of Paediatrics and Dermatology and Skin Sciences, Faculty of Medicine, University of British Columbia, Vancouver

Keywords:Pediatrics, atopic dermatitis, guideline, treatment, review, dupilumab.

Abstract:In this clinical guidelines article, we first include a brief review of the epidemiology, pathogenesis, clinical diagnoses, and scoring-scales for pediatric atopic dermatitis (AD). We then offer a set of pharmacologic treatment guidelines for infants and toddlers (12 years). We recommend irritant avoidance and liberal emollient usage as the cornerstone of treatment in all age-groups. In infants 2 years, topical corticosteroids are still considered first-line therapies, but there is sufficient safety data to utilize topical calcineurin inhibitors and topical PDE4 inhibitors as well. In children ages 2-12 years whose atopic dermatitis fails to respond to prior treatments, oral systemic immunosuppressants can be used. For adolescents >12, the biologic, dupilumab, is an additional therapeutic option. A trial of phototherapy may also be utilized in children, particularly in adolescents >12 years, if they have access to treatment. Although not currently approved for the treatment of AD, Janus-kinase (JAK) inhibitors represent a promising new class of biologics with recently completed phase III clinical trials (JADE-- MONO1/2).